The clinical outcomes of using a new cross-linked hyaluronan gel in endoscopic frontal sinus surgery

• Published in: European archives of oto-rhino-laryngology 2017-09, Vol.274 (9), p.3397-3402
• Main Authors: Dal, Teoman, Bahar, Seçil
• Format: Article
• Language: English
• Subjects: Adult; Case-Control Studies; Endoscopy; Female; Frontal Sinus - surgery; Gels; Head and Neck Surgery; Humans; Hyaluronic Acid - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Otorhinolaryngology; Rhinology; Tissue Adhesions - prevention & control; Viscosupplements - therapeutic use; Wound Healing; Young Adult
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-017-4638-0

In endoscopic sinus surgery (ESS) synechiae formation and ostial stenosis are frequently encountered. This is not uncommon after frontal recess and ostium interventions due to the narrow recess and difficult anatomy of the region. The goal of this study is to evaluate the efficacy of the new cross-linked hyaluronan gel—PureRegen ® Gel Sinus—on wound healing and synechiae prevention in endoscopic frontal sinus surgery. The study consists of two groups of patients who underwent ESS, including frontal sinus surgery. In the study group of 37 patients, PureRegen ® Gel Sinus was applied to both the frontal recess and ostium at the end of the procedure. The control group consisted of 28 patients. In this group, nasal dressing material was not applied at the end of surgery—neither to the frontal recess nor to the ostium. Postoperatively, epithelization was found to be significantly better at 2 and 4 weeks in the study group when compared with the findings in patients where no postoperative dressing was applied. In the eighth week, there was no significant difference found between the two groups in terms of epithelization. Synechiae formation was significantly lower in the PureRegen ® Gel Sinus group than the control group at all 2, 4 and 8 weeks postoperative evaluations. The effects of PureRegen ® Gel Sinus on wound healing, especially in reepithelization, have shown to occur earlier in the postoperative period. Rapid reepithelization and control of infection related granulation tissue formation with antibiotics in the early postoperative period may explain the low stenosis rate in frontal sinus ostia in PureRegen ® Gel Sinus applied patients.